The signs of trauma have been unmistakable for years: the obesity, the bombast, the bellicose defensiveness, the need to project a larger-than-life persona as compensation for low self-esteem. And then, more recently, reports of self-soothing with substances like cocaine and alcohol, followed by denial, failed commitments to sober up, more denial and, finally, treatment for addiction: a common personal trajectory, become public because the anti-hero is the mayor of Canada’s largest city. In the Jerry Springer culture of North America this man becomes a laughing stock, his plight a fodder for cheap-laugh comedians and scandal-mongering commentators.
The most telling aspect of the Rob Ford saga has been the absence of empathy towards a human being who is suffering and, clearly, has suffered all his life. Underneath Ford’s paper-thin hubris and achingly evident desperation to be liked is the pain of a child who was mistreated or, at the very least, deprived of acceptance and emotional nurture. We come to soothe ourselves through substances, food or addictive behaviours when, as young children, we were hurt and not soothed. There are no exceptions. Ford’s public drama may have been self-authored, but the distress driving it was inflicted before he had any choice in the matter. Addiction is an attempt not to feel that distress.
In my fourteen years of medical work in Vancouver’s Downtown Eastside, perhaps North America’s most concentrated area of drug use, I never met one female patient who had not been sexually abused in childhood, nor a patient of any gender who had not suffered trauma, abandonment or neglect. Nor have I ever met an addict of any kind, anywhere, who, in childhood, had not experienced significant emotional loss. This always proves to be the case, even with people who, owing to the power of self-protective denial, initially assert that they had a “happy” upbringing.
“Traumatic life experiences during childhood and adolescence were far more common in an obese population than was comfortably recognized,” wrote the authors of a landmark paper published in 2010. Their article was entitled Obesity: Problem, Or Solution, Or Both? As the research has amply demonstrated, that astute observation applies not only to overeating, but to all addictions, whether to substances or, for example, to gambling, shopping, or obsessive sexual roving. For all the problems they inevitably create, all addictions begin as a person’s forlorn attempt to solve the problem of shame, isolation, unbearable emotional hurt and emptiness.
Addiction need not remain a tragedy: neither Rob Ford’s nor that of anyone else. With recognition of the problem arises the possibility of transformation, of arriving at a state of genuine self-acceptance, vitality, honesty, and humility. That has been the experience of many human beings, even ones with severe trauma and with life circumstances not anywhere as favourable as that of the Toronto mayor. People achieving such a state may even express gratitude for the addiction itself: the harsh but truthful mentor that led them back to themselves. We call that recovery: the finding, the getting back of something precious. “I found my self when I recovered from addiction,” former addicts often say.
It is an all-too-common failing of the medical approach to addiction treatment, and of the rehab industry in general, that the pain and trauma at the core of addiction is ignored. The disturbing events that fostered the addiction remain unexplored and the emotional dynamics that keep fuelling it are unresolved. The focus, instead, is on extirpating the behaviours of addiction, which is like trying to control a house fire by siphoning away the smoke; or on the diseased brain biology of addiction, as if neurobiology were not shaped by life experience.
We need programs that do not separate the behaviours of dependency from a person’s life history, do not see the addict in isolation from the multigenerational troubles of his or her family, and do not impose an artificial and unscientific barrier between emotional experience and brain physiology.
Addiction is both a daunting challenge and an opportunity to heal, for the individual and for the family whose issues the identified addict embodies. Having incurred notoriety, the mayor of Toronto may become an inspiration to many if he is helped to salve the wounds that impelled him into compulsive substance use, if he finds the courage to accept his pain and not run from it, and the humility to acknowledge that behind the physical and political heft he has gathered there has been hiding a sensitive and vulnerable being, in need–as we all are—of compassion.
This originally appeared in the OpEd section of the Toronto Star on June 2, 2014.